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Respiratory Symptoms and Farming Practices in Farmers Associated With an Acute Febrile Illness After Organic Dust Exposure^*

^* From the Department of Preventive and Societal Medicine (Dr. Fryzek), and the Department of Internal Medicine (Drs. Von Essen, Wampler, and Nowakowski), College of Medicine, University of Nebraska Medical Center, Omaha, NE.

Correspondence to: Susanna Von Essen, MD, FCCP, Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, University of Nebraska Medical Center, Box 985300, Omaha, NE 68198-5300; e-mail: svonesse{at}UNMC.edu

Study objective: To conduct a preliminary study of occupational respiratory complaints in farmers who have experienced organic dust toxic syndrome (ODTS) symptoms.

Design: Cross-sectional.

Setting: An agricultural trade show.

Intervention: None.

Measurement and results: Two hundred ninety-seven people (204 men, 93 women) completed a questionnaire about agricultural practices, respiratory health (including history of febrile episodes while handling grain), and use of respirators. Spirometry was also performed. ODTS symptoms were described by 107 of the people (36%). A strong significant association was found between ODTS and cough or chest tightness after handling grain (odds ratio [OR], 7.5; 95% confidence ratio [CI], 4.2 to 13.5). People who experienced cough or chest tightness after handling grain were more likely to report handling grain sorghum than people who had not experienced cough or chest tightening after handling grain (OR, 2.1; 95% CI, 1.3 to 3.5). The strong association seen between ODTS and frequent use of a respirator while working in grain bins (OR, 3.9; 95% CI, 1.6 to 9.4) may indicate that farmers began using respirators after respiratory symptoms developed.

Conclusions: Having a history consistent with ODTS exposure was very common in the farmers surveyed. Farmers who had a history consistent with ODTS were more likely to report cough or chest tightness with handling grain. Exposure to grain sorghum was more likely to be associated with respiratory symptoms than was exposure to other types of grain. There is a need for additional studies to further examine the relationship between ODTS and respiratory symptoms with grain dust exposure in farmers.

Key Words: bronchitis • farming • grain dust • organic dust toxic syndrome • swine confinement

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